2011-2012
Board Minutes & Records
3301 Tamiami Trail East
Building F, 4th Floor
Naples, FL 34112
Expires
'If /ZO I;)"
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name
(Y) ; cha e.-I /l. (7J f fre Ii2
Date
(~/~ ~/I /
Business Address sor;9 hmIOn1,' ria:! g,
/VCL tJ/e~ 1 FL- 3 if//3
. I
Business TelephoneC~37) '-I) )-0 'XI?
E-Mail/lJC-tr6f?/tS5dC @/'t-OL-,LOJ'Y\
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1). ;n I' c.J,.o e r J4, /?lq:re~
//::>6 '/Y)o rnl n5 '5/de.. Dr, u e..
Nc<-;,()Je-s I I~ 3t.J/{) 3
I I
2). /7jC(yt. L r/-. /l S~c..1 'a. Ie ~
Sa? 9 /C;h1laMI' "/rco I L;
$6.. yJ/e 5 , /:::-L "39// 3
, /
PLEASE ATTACH ADDITIONAL SHEETS IF NECESSARY
State of Florida
County of Collier
.'l "f' I
. om to and flbscribed beti>re me on this CjcA.;; I G
Hy IYJ, (I\c;-(J f1( (p, who is personally known to
C. DC; as identification and
; .I
,""'''' / \..J / /)q
~~-:'t'1J.Y"II~... JANET L. KLINE Y I "II .
i.~.~ Notary Public. State of Florida BY: i ,.:J"j. /C- v
\~i My Comm. Expir81 Jul 23. 2014 , " .
";:'l,,9r.t,\~~ Commission # DO 977542 Depu~y ClerkINotary Pubhc
e annu regIstration fee is $25.00 per Lobbyist, accorMllg to CoUier County
Ordinance No. 2003-53, as amended by Ordinance 2004-05 and Ordinance 2007-24.
Please make payment and mail to: Collier County Clerk of Courts or
Dwight E. Brock, Clerk of Courts (at the address listed at the top of the form).
Dwight E. Brock
Clerk of the Circuit Court
Receipt# 007189401
9/26/2011 2:32:51 PM
(Q)~~~'O (C~ 0 (sJ U [r;~ c~~e~x~~ H rV)G
Customer
MICHAEL MCGEE
MCGEE & ASSOCIATES
5079 TAMIAMI TRL E
NAPLES, FL 34113-4128
DeDutv Clerk
BMR CASHIER
MinutesandRecords@CollierClerk.co
m
239-252-2646
Clerk Office Location
Collier County Govt. Center
Building F, 4th Floor
3299 Tamiami Trail East, Suite
401
P.O. Box 413044
Naples, Florida 34101-3044
1 Product
QUANTITY DESCRIPTION
1 BMR Lobbyist Registration
UNIT COST
$25.00
TOTAL AMOUNT DUE
Check# 6079
BALANCE DUE
AMOUNT
$25.00
$25.00
($25.00)
$0.00
Note:
Disclaimer: All transactions are subject to review/verification. The Clerk reserves the right to correct for clerical errors and to
assess or refund charges as needed.
@@DDD@o@D@~@@1Ji1i)
Page 1 of 1